起源于垂体的血管内大B细胞淋巴瘤：一例报告
Intravascular large B-cell lymphoma arising in the pituitary gland: A case report.
作者信息
Jang Kyu Yun, Ahn Ae Ri
机构信息
Departments of Pathology, Jeonbuk National University Medical School, Research Institute of Clinical Medicine of Jeonbuk National University, Biomedical Research Institute of Jeonbuk National University Hospital, and Research Institute for Endocrine Sciences, Jeonju, Jeonbuk, Republic of Korea.
出版信息
Medicine (Baltimore). 2024 Dec 13;103(50):e40995. doi: 10.1097/MD.0000000000040995.
RATIONALE
Primary pituitary lymphoma is defined as a lymphoma that develops only in the pituitary gland without involvement of other areas.
PATIENT CONCERNS
We present the case of a 61-year-old female patient who underwent an endonasal transsphenoidal approach for the preoperative diagnosis of a pituitary macroadenoma based on radiological findings.
DIAGNOSES
Microscopically, the capillaries were distended by tumor cells. The high-magnification view showed large cells with vesicular nuclei and single or multiple prominent nucleoli, with mitotic figures often observed within the intravascular space.
INTERVENTIONS
Immunohistochemical staining showed strong positivity for CD45 and pan-B cell markers such as CD19 and CD20. The postoperative diagnosis was intravascular large B-cell lymphoma of the pituitary gland.
OUTCOMES
Next-generation sequencing revealed alterations in 12 genes: ARID5B, BCL2, CD79B, ETV6, HLA-B, LRRC7, MYD88, PIM1, POT1, PTPN11, RASA1, and SRSF2.
LESSONS
To our knowledge, this is the first case report of pituitary intravascular large B-cell lymphoma.
理论依据
原发性垂体淋巴瘤被定义为仅在垂体发生而不累及其他部位的淋巴瘤。
患者情况
我们报告一例61岁女性患者，根据影像学检查结果，该患者接受了经鼻蝶窦入路手术以对垂体大腺瘤进行术前诊断。
诊断
显微镜下，肿瘤细胞使毛细血管扩张。高倍视野显示大细胞，核呈泡状，有单个或多个明显核仁，血管腔内常可见有丝分裂象。
干预措施
免疫组化染色显示CD45以及CD19和CD20等泛B细胞标志物呈强阳性。术后诊断为垂体血管内大B细胞淋巴瘤。
结果
二代测序显示12个基因发生改变：ARID5B、BCL2、CD79B、ETV6、HLA - B、LRRC7、MYD88、PIM1、POT1、PTPN11、RASA1和SRSF2。
经验教训
据我们所知，这是垂体血管内大B细胞淋巴瘤的首例病例报告。
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